Jang Ji-Young;Cho Moon-June;Kim Ki-Hwan;Song Chang-Joon;Kim Byoung-Kook;Kim Jun-Sang;Kim Jae-Sung
Korean Journal of Head & Neck Oncology
/
v.16
no.2
/
pp.172-176
/
2000
Objectives: To improve local control and reduce toxicity, 3-D conformal radiotherapy was used as a boost the primary tumor site following fractionated radiotherapy in patients with nasopharyngeal carcinoma. Materials and Methods: Eight patients with previously untreated nasopharyngeal carcinomas were treated with 3-D conformal radiotherapy following fractionated radiotherapy from September 1998 to April 2000. All patients had biopsy confirmation of disease before radiation therapy. Stages were II in 1, III in 5, and IV in 2. Two patients received cisplatin based chemotherapy in addition to radiation therapy; induction chemotherapy in 1, concurrent chemoradiation in 1. 3-D conformal radiotherapy delivered using 6MV Linac as a boost(range 25.2-28.8Gy, median 25.7Gy) following conventionally fractionated radiotherapy(range 50.4Gy). Average total dose ranged from 75.6-79.2Gy(median 76Gy). Follow-up time was 4-21 months(median 9.6 months). Results: Seven of 8 patients were evaluated radiologically within 3 months after completion of radiation therapy. All 7 patients were seen complete remission. One of 7 patients had distant metastasis after 5 months and local failure after 7 months. The tree interval of local recurrence was ranged from 4 - 21 months(median 10.2 months). One patient without radiological evaluation got complete remission clinically. Treatment related toxicity was grade 1-3 xerostomia, dysphagia, and mucositis. During 3-D conformal radiotherapy, there was no aggravation of any toxicity. Conclusion: Although the number of patients was small and follow-up period was short, 3-D conformal radiotherapy following conventional radiotherapy improved tumor control and dose escalation without increased toxicity. Survival and late toxicity should be evaluated through long term follow-up. In addition, it is necessary to confirm the benefits of 3-D conformal radiotherapy in nasopharyngeal carcinoma with randomized trial.
Relapse is one of the most series problems in alcoholics treatment. Previous studies have shown that significant proportions of treated alcoholics show an early relapse and go through a chronic phase. It is necessity to find more effective relapse prevention program. The Purpose of this study was to develop a relapse prevention program that emphasis on group activities using various action methods. Previous studies revealed that there was no effective therapeutic strategy to prevent relapse and proposed that action methods were more practical ways to be able ti cope with high-risk situation than verbal methods such as discussions and lectures. The special attempt of this program was the application of various actions methods and the integration of many psychosocial therapeutic strategies as compared with many relapse prevention programs. The theoretical framework of this relapse prevention program was based on mainly the Marlatt's Relapse Prevention model and Prochescha and DiClemente's Transtheoretical model. This Program consists of eight structure sessions. Every session has three phase: Warm-up phase, action phase, and sharing phase as sociodrama structure. Sociodrama is based on many of the principles of adult learning. And sociodrama looks at how groups work through an understanding of systems and role theory. Therefore, in working with a group a therapist might explore with them the roles that people play, roles that are missing at present such a visionary and how people can develop new roles or new ways of playing existing roles. The researchers explained the purpose of this study to all participants after their agreement to participate. Voluntary informed consent was obtained from all participants. Every session allows participants to recognize personal specific high-risk situation and to examine possible coping behaviors creatively. Multiple solutions can be proposed, tested and evaluated dramatically, giving new insights or breakthroughs in thinking. This is vital for the initiation of change, and if appropriate, expanding new role development. The first two sessions aim at understanding of relapse process and recognize of high-risk situations focused on orientation about action methods. The next four sessions deal with high-risk situations. The last two sessions give participants opportunities to venture new life-styles. The methods and approaches used in this program utilized as a tool to explore and practice possible coping strategies. and this program can contribute to prevent relapse episode if tune with the particular high-risk situation by using active practices in safe environment.
Journal of the Korean Institute of Oriental Medical Informatics
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v.17
no.2
/
pp.82-129
/
2011
"Beijijiufa" is a medical book republished by Sun Ju Qing in 1245. He compiled this book having added "Qizhumajiufa" and "Zhugejingyanbeijiyaofang" to the contents of "Beijijiufa" authored by Wen Ren Qi Nian. In "Beijijiufa" the author described treatment methods making use of moxibustion methods in connection with 22 cases of acute diseases. The author had collected the moxibustion methods used to treat acute diseases, which had been practiced by the medical practitioners of many generations, and quoted total 13 medical men's practices. In the book, the greatest parts of details were quoted especially from the writings of Sun Si Miao and Ge Hong, and this shows that the medical philosophies of both Sun Si Miao and Ge Hong were reflected onto "Beijijiufa". He had differed on his moxibustion practice: the size of moxa wool, the number of moxibustion treatment, and method of moxibustion for male and female were differed from one another according to the disease. As to the area of moxibustion, he chose the body parts around under four limbs and joints, and mostly used extraordinary acupoints rather than twelve main meridians. In his descriptions of finding meridian points, he did not describe it by its specific name of the reaction point, but explained the location of moxibustion points in detail through pictures. "Qizhumajiufa" is related to moxibustion method and prescriptions to treat surgical diseases, like skin boils or furuncle on the back, etc. He easily explained the method to find the meridian points for moxibustion treatment by using particular way through diagrams and pictures. Eight prescriptions he used were the collections among the historical practices of medical practitioners of many generations for skin boils which showed excellent therapeutic actions. In "Zhugejingyanbeijiyaofang", there are prescribed for 36 disease, also is the records of treatment methods for medical emergency which would be encountered easily in everyday life. As to therapeutic remedies, varied treatment methods, including the treatment by means of pasting and attaching medicinal substance to the spot, the treatment by means of mixing medicinal substance with alcoholic beverage, cleansing method, smoke inhalation remedy etc. were introduced. In "Beijijiufa" moxibustion was regarded as a top priority for treatment of acute disease, and the author strived to present remedies to the readers as easily as possible through 19 pictures. Regarding prescriptions, the author introduced diverse treatment methods with respect to various disease symptoms, and described the method to treat disease symptoms making use of medicinal ingredients which can easily be found in daily life. Likewise, "Beijijiufa" compiled by Sun Ju Qing was intended for clinical practice, and was indeed a medical book having been utilized for treatment of acute diseases in those days.
Guardo, Laura Alonso;Gala, Carlos Cano;Poveda, David Sanchez;Juan, Pablo Rueda;Sanchez Montero, Francisco Jose;Garzon Sanchez, Jose Carlos;Lamas, Juan Ignacio Santos;Sanchez Hernandez, Miguel Vicente
The Korean Journal of Pain
/
v.29
no.1
/
pp.23-28
/
2016
Background: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode ($Interstim^{(R)}$, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. Methods: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. Results: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. Conclusions: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.
Park, Seong-Hyun;Lee, Sang-Woo;Kang, Dong-Hun;Hwang, Jeong-Hyun;Sung, Joo-Kyung;Hwang, Sung-Kyoo
Journal of Korean Neurosurgical Society
/
v.49
no.5
/
pp.278-283
/
2011
Objective : The purpose of this study was to evaluate whether $^{18}F$-fluorodeoxyglucose positron emission tomography (FOG-PET) can be used to assess the therapeutic response of brain abscess. Methods : A study was conducted on 10 consecutive patients with brain abscess, Magnetic resonance imaging (MRI) with diffuse-weighted imaging (DWI) was performed at 3 and 6 weeks after surgical treatment and intravenous antibiotics therapy and FOG-PET at 6 weeks after treatment. The extent of the abscess, signal changes on MRI, and FOG-PET standardized uptake values were analyzed and correlated with the response to therapy. Results : Aspiration or craniotomy with excision of the abscess followed by intravenous antibiotics for 6-8 weeks resulted in good recovery with no recurrence. In 10 patients, two had low signal intensity on the DWI; one had no uptake on FOG-PET imaging after 6 weeks antibiotics and discontinued intravenous treatment, but the other patient had diffuse, increased uptake on FOG-PET imaging after 6 weeks antibiotics and underwent an additional 2 weeks of intravenous antibiotics. The remaining eight patients had high signals on the DWI. Four had no uptake on FOG-PET imaging and the treatment period varied from 6 to 8 weeks (mean, 6.75 weeks). Among the other four patients, FOG was accumulated in a diffuse or local area corresponding to a high signal area within the DWI and 2 weeks of intravenous antibiotics was added. Conclusion : MRI plus FOG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy.
Shin, Jae Won;Jung, Yun Seob;Park, Kyungsoo;Lee, Soon Min;Eun, Ho Seon;Park, Min Soo;Park, Kook In;Namgung, Ran
Clinical and Experimental Pediatrics
/
v.60
no.2
/
pp.50-54
/
2017
Purpose: The aims of this study were to evaluate the safety and pharmacokinetics of levetiracetam (LEV) in neonates with seizures and to establish a population pharmacokinetics (PPK) model by using the software NONMEM. Methods: A retrospective analysis of 18 neonatal patients with seizures, who were treated with LEV, including 151 serum samples, was performed. The mean loading dose was 20 mg/kg, followed by a mean maintenance dose of 29 mg/kg/day. Results: Seventeen neonates (94%) had seizure cessation within 1 week and 16 (84%) remained seizure-free at 30 days under the LEV therapy. The mean serum concentration of LEV was $8.7{\mu}g/mL$. Eight samples (5%) were found above the therapeutic range. No serious adverse effects were detected. In the PPK analysis for Korean neonates, the half-life was 9.6 hours; clearance, 0.357 L/hr; and volume of distribution, 4.947 L, showing differences from those in adults. Conclusion: LEV is a safe and effective option for the treatment of neonatal seizures with careful therapeutic drug monitoring.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.30
no.1
/
pp.74-86
/
2017
Objectives : This study aimed to assess the scientific evidence for the use of Hwanglyeonhaedok-tang, a traditional herbal formula, in the treatment of rhinitis, and prepare the basis for the investigational new drug application by analyzing the experimental studies. Methods : Ten electronic databases were searched up to December, 2016 without language limitation. Experimental studies on the anti-inflammatory and anti-allergic effects of Hwanglyeonhaedok-tang against rhinitis were included. We extracted data about study design, characteristics of intervention, outcomes, and pharmacological effects from the included studies and summarized them. Results : Eight hundred and thirty-three potentially relevant studies were identified, of which 18 experimental studies met our inclusion criteria. Of 18 included studies, 5 had conducted cell viability test, and all studies had reported that Hwanglyeonhaedok-tang was non-cytotoxic. Hwanglyeonhaedok-tang exhibits anti-inflammatory effect by regulating the inflammation-related cytokines including nitric oxide(NO), prostaglandin $E_2(PGE_2)$, interleukin-6(IL-6), and tumor necrosis $factor-{\alpha}(TNF-{\alpha})$ in vitro and in vivo. Hwanglyeonhaedok-tang exhibits anti-allergic effect by suppressing eosinophil, and histamine levels. Hwanglyeonhaedok-tang helps in the recovery of nasal mucous membrane by supressing goblet cells, heat shock protein 70, and substance P. Conclusions : This study suggests that Hwanglyeonhaedok-tang has the potential to be developed as therapeutic agent for rhinitis. Further experimental and clinical studies needed to be performed to prove the safety and efficacy.
Objective: Low level laser treatment (LLLT) is widely used in physical therapy practice. It is combined with physical therapy or LLLT alone. The purpose of this study is to evaluate the effectiveness of LLLT on patients' perception of general wrist pain. Design: Longitudinal study. Methods: Forty-eight subjects with wrist pain who were in the age range of 18-70 years old were examined. The subjects were asked, via an interview and a visual analog scale, to grade their wrist pain. They were asked to rotate their wrists through full range of motion and the angle at which any pain occurred was assessed. Each subject was then exposed to one of the following: 1) treatment with an infrared laser with the power turned off (placebo), 2) treatment with an infrared therapeutic laser, 3) treatment with a red therapeutic laser, 4) treatment with an ultraviolet laser, 5) treatment with a blue laser, 6) treatment with a Mickey Mouse flashlight. The duration of the treatment was 3 sessions in 3 days. Results: The results of the experiments showed that while pain was reduced both immediately after and the next day after laser therapy (p<0.05), there was no significant difference between the laser groups and the placebo group. However, the Mickey Mouse flashlight treatment groups had a greater range of motion than the laser groups (p<0.05). Conclusions: While pain was reduced in all laser groups, it was probably a placebo effect. The Mickey Mouse flashlight group probably received benefit from the heat of the flashlight.
Mohamed Fares Mahjoubi;Anis Ben Dhaou;Mohamed Maatouk;Nada Essid;Bochra Rezgui;Yasser Karoui;Mounir Ben Moussa
Annals of Hepato-Biliary-Pancreatic Surgery
/
v.27
no.4
/
pp.388-393
/
2023
Backgrounds/Aims: Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. Methods: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis. Results: There were 47 patients. Twenty-eight percent was in the first trimester of pregnancy, 40% in the second, and 32% in the third trimester. Abdominal pain was located in the right hypochondrium in 75% of cases. Fever was noted in 21% of cases. C-reactive protein was elevated in 39% of patients. Cholestasis markers were high in four patients. Abdominal ultrasound showed a distended gallbladder in 39 patients, with thickened wall in 34 patients, and gallbladder lithiasis in all cases. No patient had a dilated main bile duct. All patients received intravenous antibiotic therapy. Tocolysis was indicated in 32 patients. Laparoscopic cholecystectomy was performed in 32 cases (68%), and open cholecystectomy in 15 cases (32%). Postoperative course was uneventful in 42 patients, and complicated in 5 patients. Rate of complications was statistically higher after open cholecystectomy (p = 0.003). Morbidity rate was higher in the third trimester (p = 0.003). Conclusions: Delay in the diagnosis of acute cholecystitis during pregnancy can lead to serious complications. Management is based on antibiotic therapy and cholecystectomy. Laparoscopic cholecystectomy appears to be less morbid than open cholecystectomy.
Objective: This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided minimally invasive treatment in patients with parathyroid lesions. Materials and Methods: This study included 27 patients who had undergone US-guided radiofrequency ablation (RFA) or ethanol ablation (EA) for parathyroid lesions between January 2010 and 2018. RFA was performed in 19 patients with primary hyperparathyroidism (PHPT, n = 11) or secondary hyperparathyroidism (SHPT, n = 8), and EA was performed in eight patients with symptomatic nonfunctioning parathyroid cysts (SNPCs). Nodule size, volume, serum parathyroid hormone (PTH) and calcium levels were recorded before and after treatment. Complications were evaluated during and after treatment. Results: In patients with PHPT, significant reductions in size and volume were noted after RFA at 6- and 12-month follow-up (all, p < 0.05). Seven nodules nearly completely disappeared (residual volume < 0.1 mL); serum PTH and calcium levels were reduced to normal ranges (7/11, 63.6%). Four patients experienced partial reductions of serum PTH and calcium levels (4/11, 36.4%). In patients with SHPT, three experienced therapeutic response of serum PTH (3/8, 37.5%), while five showed persistent hyperparathyroidism (5/8, 62.5%) within 6 months after RFA. In patients with SNPCs, EA resulted in significant reductions in cyst size and volume (all, p < 0.05) at the last follow-up. A total of four complications (two transient hypocalcemia [RFA], one permanent [RFA], and one transient [EA] hoarseness) were observed. Conclusion: Minimally invasive treatments, such as RFA and EA, may serve as therapeutic alternatives for patients with PHPT or SNPCs; they may have limited usefulness in patients with SHPT.
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